Category

Synonyms

Background

Borage (Borago officinalis) is an herb native to Syria that has spread throughout the Middle East and Mediterranean. Borage flowers and leaves may be eaten and borage seeds are often pressed to produce oil very high in gamma-linolenic acid (GLA).

Borage is popularly used for premenstrual syndrome (PMS) and menopausal symptoms. Borage is also popular among elderly women. Borage is known for its anti-inflammatory properties and has been studied for the treatment of gum disease, rheumatoid arthritis, and asthma.

There is currently controversy about the safety of borage. Consumers should use caution when taking borage as there have been cases of poisoning after confusion with foxglove.

Evidence

DISCLAIMER:
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acute respiratory distress syndrome:
Acute respiratory distress syndrome occurs when the lung malfunctions due to injury to the small air sacs and the capillaries of the lungs. Borage may improve heart and lung function and reduce lung inflammation in acute respiratory distress syndrome.
Grade: B

Periodontitis / gingivitis:
Preliminary evidence suggests that borage has anti-inflammatory effects that may make it beneficial in treating periodontitis (gum disease). Additional research is needed to determine the best dosing and administration of borage oil.
Grade: B

Rheumatoid arthritis:
Preliminary evidence suggests that gamma linolenic acid (GLA) has known anti-inflammatory effects that may make it beneficial in treating rheumatoid arthritis. Additional research is needed to determine the optimal dose and administration.
Grade: B

Alcohol-induced hangover:
Borage oil may help treat or prevent alcohol-induced hangovers, although additional study is needed in this area.
Grade: C

Asthma:
Preliminary evidence suggests that gamma linolenic acid (GLA) may have some immunosuppressant activity that may be helpful in reducing asthma symptoms.
Grade: C

Atopic dermatitis:
Atopic dermatitis is a skin disorder that is characterized by itching, scaling, thickening of the skin and is usually located on the face, elbows, knees, and arms. The evidence for borage oil in the treatment of atopic dermatitis is mixed. Additional study is needed in this area.
Grade: C

Cystic fibrosis:
Cystic fibrosis is a genetic disorder affecting the mucus lining of the lungs leading to breathing problems and other difficulties. Preliminary evidence indicated that borage oil may have some benefits in cystic fibrosis patients.
Grade: C

Hyperlipidemia:
Hyperlipidemia means that there are excess levels of fats in the blood. These fats can be triglycerides or cholesterol. Hyperlipidemia is often associated with increased risk of heart disease and strokes. Gamma linolenic acid may decrease plasma triglyceride levels and increase HDL-cholesterol concentration. However, more research is needed to define borage's effects on lipid levels in the blood.
Grade: C

Malnutrition (inflammation complex syndrome):
Currently, there is insufficient available evidence evaluating the effectiveness of borage in the treatment of malnutrition.
Grade: C

Seborrheic dermatitis (infantile):
Seborrheic dermatitis is a type of inflammatory skin rash. Currently, there is insufficient evidence to support borage in the treatment of seborrheic dermatitis.
Grade: C

Stress:
Borage oil may decrease heart changes to acute stress. More high quality studies are needed in this area.
Grade: C

Supplementation in preterm and very low birthweight infants (fatty acids):
A borage oil-containing formula does not appear to affect preterm and very low birth weight infants, although more study is needed in this area.
Grade: C

Tradition

WARNING:
DISCLAIMER:
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Anti-inflammatory, antioxidant, autoimmune disorders, cancer, H. pylori infection, immune function, menopausal symptoms, premenstrual syndrome (PMS), seborrheic dermatitis (adults).

Dosing

Adults (over 18 years old)

Borage is likely safe when used in food or spice amounts or when 1-3 grams is used daily in healthy adults for up to 24 weeks.

There is no proven effective dose for borage. However, 2-3 grams daily GLA (borage oil) for 24 weeks to 12 months has been used for asthma. For atopic eczema, 500-3,000 milligrams of borage oil-containing capsules daily for 12-24 weeks has been used.

Children (under 18 years old)

There is no proven safe or effective dose for borage in children. Nonetheless, two capsules of borage oil twice daily for 12 weeks have been used. For prevention of atopic dermatitis, a borage oil supplement containing 100 milligrams gamma linolenic acid daily for the first six months of life has been used.

Safety

DISCLAIMER:
Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to borage or its constituents.

Side Effects and Warnings

Borage has been confused with foxglove and ingestion of foxglove leaves has caused accidental poisoning.

Avoid in patients with compromised immune systems or similar immunological conditions.

Pregnancy and Breastfeeding

Borage is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. One pregnant woman using borage seed oil complained of mild intestinal gas. Gamma linolenic acid, which is found in borage, may alter breast milk production.

Interactions

Interactions with Drugs

Borage may have antibacterial effects against Helicobacter pylori. Use cautiously with antibiotics and antiulcer medications due to possible additive effects.

Borage may increase the risk of bleeding, especially when taken with drugs that increase the risk of bleeding, such as warfarin therapy.

Preliminary evidence suggests that borage may lower the seizure threshold. Use cautiously in patients with seizures or taking anticonvulsant medications.

Preliminary evidence suggests that borage oil may have anti-inflammatory properties. Use cautiously with anti-inflammatory medications due to possible additive effects.

Although not well studied in humans, gamma linolenic acid may decrease plasma triglyceride levels and may increase HDL-cholesterol concentration. Use cautiously in patients taking cholesterol-lowering medications due to possible additive effects.

Interactions with Herbs and Dietary Supplements

Although not well studied in humans, borage may have antibacterial effects against Helicobacter pylori. Use cautiously with herbs and supplement that may have antibacterial or antiulcer activity.

Preliminary evidence suggests that borage seed oil may potentially increase the risk of bleeding or potentiate the effects of warfarin therapy. Use cautiously with bleeding disorders or with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto.

Preliminary evidence suggests that borage may lower the seizure threshold. Use cautiously in patients with seizures or taking anticonvulsant herbs or supplements.

Preliminary evidence suggests that borage oil may have anti-inflammatory properties. Use cautiously with anti-inflammatory herbs or supplements due to possible additive effects.

Although not well studied in humans, gamma linolenic acid may decrease plasma triglyceride levels and may increase HDL-cholesterol concentration. Use cautiously in patients taking cholesterol-lowering herbs, such as red yeast rice, due to possible additive effects.

Borage oil may alter heart function. Use cautiously in patients with heart conditions or taking cardiovascular herbs or supplements.

Preliminary evidence suggests that gamma linolenic acid may alter immune responses. Use cautiously with other immunomodulators.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Nicole Giese, MS (Natural Standard Research Collaboration); J. Kathryn Bryan, BA (Natural Standard Research Collaboration); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

DISCLAIMER:
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.